Chemical peel is most common procedure for reduction of serious acne scar. Chemical peels have actually been used for hundreds of years and have a proven safety record in the proper hands. However, chemical peels are not for everyone.
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Laser resurfacing, dermabrasion and chemical peels are three most common procedures for reduction of serious acne scar.
Chemical peels, also known as chemical resurfacing, are techniques that employ chemical treatments to improve and smooth the texture of the facial skin by removing its damaged outer layers. Chemical peels produce controlled injury to the skin which promotes growth of new skin with improved appearance. Chemical peels are used for the treatment of photoaging (from sun damage), wrinkles, scarring, acne, precancerous lesions, and discoloration (or dyschromia). Many different chemicals are used for chemical peels and include glycolic acid, trichloroacetic acid (TCA), salicylic acid, “Jessners” solution, and phenol.
The different degrees of injury to the skin is produced by different chemical solutions. There are two layers of the skin; the inner layer is called the dermis and the outer layer, the epidermis. Deeper peels (e.g. phenol peels) produce injury within the dermis and can reverse moderate-to-severe photoaging and wrinkles. Superficial peels (such as glycolic acid peels) produce very superficial injury, confined to the epidermis. Superficial peels can help improve conditions such as acne and discoloration. In general, the deeper peels offer the most dramatic results but require longer recovery and carry a higher risk of complications.
Chemical peels procedure usually begin with vigorous cleansing of the skin. The depth of the peel depends on the chemical used. Very light peels (e.g. low potency glycolic acid, 10-20% TCA) only penetrate the dead skin cells that sit atop the epidermis and produce almost no injury. Sometimes, this level of peel is called “exfoliation”. Light peels (70% glycolic acid, 25-35% TCA) injure the entire epidermis and stimulate the regeneration of a new epidermis. This level of chemical peel may produce a burning sensation during the procedure. Recovery from light peels is quick- hence the name “lunchtime peel”. Improvement in the appearance of photoaged skin and scarring is usually subtle at best. Medium depth peels involve injury to the upper level of the dermis. Injury to the dermis stimulates the formation of collagen and “plumps” up the skin. Usually 35% TCA, in combination with another chemical such as glycolic acid, is used safely with minimal discomfort. Burning is the most common complaint during the procedure and this is usually well controlled with cool compresses or topical anesthetics.
Deep peels involve injury to the mid dermis and are usually performed using a phenol solution and anesthesia. A deep chemical peel may offer dramatic results such as elimination of deep furrows and scars. However, complications such as scarring, permanent textural changes, darkening and redness of the skin can occur. Furthermore, during a deep peel, anesthesia must be used and vital signs must be monitored throughout the procedure. Recovery from a deep peel requires occlusive bandages and can take up to a month under normal circumstances. The phenol peel should only be performed by qualified physicians with proper monitoring equipment.
Depending upon the peel, you may be a candidate for one if you have slight wrinkles, hyperpigmentations, splotchiness, unevenness, acne, acne scars, black heads or sun damaged skin. You may not be a candidate if you have herpes as this can spread to your healing skin and cause great, weeping sores which will damage and scar your skin. Ask your primary physician for a release and perhaps a prescription for a oral medications such as Zovirax. This will decrease your risk of an outbreak. If your primary care physician does not release you or opposes to your having a peel - DON’T take that chance. Also, deeper peels may not be suitable for you if you are prone to keloids or hyper- and hypopigmentation
Most peels are performed in less than one hour, depending on size of the area being treated.
The state of your skin after a peel depends on what kind of peel you had. The superficial peels have limited effects, the medium peels may cause some redness and the deeper peels may require weeks to recover.
If you’ve had a phenol peel, your face may become quite swollen. Your eyes may even be swollen shut temporarily. You will need someone to help care for you for a day or two. You may also be limited to a liquid diet and advised not to talk very much during the first few days of recovery.
The superficial peels are usually done several times over the course of several months. The deeper peels usually only need to be performed once to achieve the desired effect. Regardless of the technique, you will likely need repeat treatments in the future. You and your physician will decide what is best for you.
With good sun protection, results can last months to years, depending on the depth of the peel. Generally, the deeper peels have a more long lasting effect.
Superficial peels are quite safe although rarely minor irritation of the skin can occur. The risks of deeper peels include infection, scarring, redness, and discoloration. Furthermore, during a deep peel, anesthesia must be used and vital signs must be monitored throughout the procedure.
Superficial peels require no recovery time (hence the name “lunchtime peel”). Recovery from a deep peel requires occlusive bandages and can take weeks to months under normal circumstances.
The cost is variable and depends on the depth of the peel and how many peels are needed. While the American Society of Plastic Surgeons says the average cost of a chemical peel in the U.S. is $607, prices vary widely depending on the procedure and overall economic conditions where you live. For instance, one mild face peel costs around $100 per application but a Phenol full face peel can cost $3000 to $4000. And those are doctor’s fees. Be sure and check what other associated fees are involved before proceeding.
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